Gastro Esophageal Reflux

WHAT IS THE GASTRO ESOPHAGEAL REFLUX?

Gastro esophageal Reflux, also known as GERD, is the passage from the gastric contents of the stomach into the esophagus. This is not considered pathological; if gastro esophageal reflux occurs on sporadic occasions of time, the time of contact of the gastric acid with the esophageal mucosa is brief and if the resistance of the esophagus is conserved to aggressive factors.

When there is an imbalance in the attacking elements and defense elements of the esophageal mucosa, it is that the GERD occurs.

The causes that benefit the development of the disease are many:

Alteration of the lower esophageal sphincter: The sphincter is a muscular ring that surrounds the esophagus, at the junction with the stomach, it is closed and prevents the stomach contents from returning to the esophagus, if the sphincter reduces the pressure at rest, it loosens and does not perform well its function will produce reflux.
Alteration of esophageal clearance, the esophagus rapidly and completely discharges gastric reflux contents.
Alteration of mucosal resistance to resist aggressive agents, can benefit the onset of disease and injury to the esophagus.

GERD is one of the most frequent problems, up to 15% of the patients suffer reflux once a week and approximately 7% suffer daily.

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Symptom

Heartburn is the most common symptom of reflux, a burning sensation in the area of the sternum. The heartburn increases if the patient makes copious meals and lies down after eating.
Regurgitation: You can feel something solid and liquid at once in the mouth that is sour.
Difficulty swallowing may occur.
Chest pain.
Belching
Pain in the abdomen.
Feeling like vomiting and sometimes the patient vomitis.
Hiccup.
Sensation of heaviness after eating.
Respiratory problems such as: cough at night, bronchitis, chronic asthma, pneumonia etc.
Discomfort in the pharynx and larynx.
Aphonia.
Sensation of "something" in the throat.

In children is present with excessive regurgitation and respiratory symptoms, there may also be growth retardation, sporadic torticollis and anemia.

Diagnosis

Regularly a diagnosis is made according to the symptoms that the patient describes to his doctor, if the clinical history is the traditional one that leads to this disease, then the treatment is indicated directly to him without more need of studies.

However, when the case is not as clear, tests such as PH measurement in the esophagus or PHmetria are performed. This test consists of evaluating the acid in the esophagus and measuring the amount of reflux.

The other study to indicate may be an endoscopy and thus evaluate the degree of gastroesophageal reflux to see if there have been repercussions in the esophageal mucosa.

Complications

Esophagitis is one of the complications that can get to suffer there are two types of esophagitis:

Mild Esophagitis: Although it appears that the mucosa is normal, microscopic lesions have resulted from the introduction of inflammatory cells into the mucosa.
Erosive Esophagitis: The mucosa was damaged and looks red and ulcerated.
Barrett's esophagus: The stomach and esophagus are covered by cells that cover them each and are distinct, however when there is reflux, the lining of the esophagus changes and becomes like that of the stomach to better support the acidity. This is called metaplasia. An endoscopy is used to make the diagnosis and a biopsy is taken to analyze it and evaluate that there is no malignant risk.
Esophagitis stenosis: This results when the gastro esophageal reflux is continuous and severe, presents with patients who have not treated their esophagitis, manifests with difficulty swallowing, is treated with dilatations, and a sample is taken to analyze the laboratory and eliminate the possibility that there is something evil.
Esophageal ulcer: This condition is more common if it has been diagnosed with Barrett's esophagus, causing acute hemorrhage and perforation. The diagnosis is made by endoscopy and a biopsy is performed to rule out malignancy.
Digestive bleeding: This is a common complication especially if anemia occurs.

Treatment

The purpose of treatment is to relieve the patient’s symptoms, to cure esophagitis and to avoid gastro esophageal reflux. Treatment can range from changes in lifestyle, medications and surgery if necessary.

Each case of each patient is particular, so you have to visit the doctor and describe your case so that the doctor can help you in the best possible way for you.

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